Current issues of diagnosis and treatment of eosinophilic granulomatosis with polyangiitis

A.L. Chudinov^1,2, O.V. Inamova^1,2

¹Clinical Rheumatological Hospital No. 25, St. Petersburg

²I.I. Mechnikov North-Western State Medical University, St. Petersburg

Eosinophilic granulomatosis with polyangiitis (EGPA; formerly known as Churg–Strauss syndrome) is a form of systemic necrotizing vasculitis predominantly affecting small-diameter blood vessels. It is associated with overproduction of antineutrophil cytoplasmic antibodies (ANCA), granulomatous inflammation, and eosinophilia. EGPA is characterized by heterogeneity of clinical manifestations, a high risk of life-threatening complications, and remains a complex challenge for clinicians, requiring a multidisciplinary approach. This article presents current data on the diagnosis and treatment of EGPA, including the latest international guidelines. Modern diagnostics are based on a combination of clinical criteria (asthma, eosinophilia, polyneuropathy, involvement of the lungs and ENT organs), histological confirmation of vasculitis, as well as immunological assessment. Glucocorticoids remain central to therapy, but attention is increasingly focused on minimizing their cumulative dose in the context of targeted therapies, including interleukin-5 blockade. Severe forms of EGPA require the use of immunosuppressants (cyclophosphamide, rituximab), followed by transition to maintenance therapy.

Keywords: eosinophilic granulomatosis with polyangiitis, systemic vasculitis, antineutrophil cytoplasmic antibodies, interleukin-5, benralizumab, mepolizumab, rituximab.

For citation: Chudinov A.L., Inamova O.V. Current issues of diagnosis and treatment of eosinophilic granulomatosis with polyangiitis. RMJ. 2025;5:36–40. DOI: 10.32364/2225-2282-2025-5-7